Heart disease remains the leading cause of death in America despite all the efforts to lower cholesterol levels and reduce blood pressure with a variety of pharmaceuticals. Heart disease continues to be the number one killer because the most important preventative measure is often ignored. The most important preventative measure is avoiding processed and refined foods and eating a whole food diet along with maintaining a consistent exercise program.

       A whole food diet emphasizing organically grown fresh fruits and vegetables, unprocessed whole grains and legumes, nuts and seeds and high quality animal products will go a long way toward maintaining proper levels of cholesterol and blood pressure without the need for pharmaceuticals.  Besides controlling for cholesterol and blood pressure, a whole food diet plus regular exercise will reduce stress, maintain proper weight and facilitate proper triglyceride, homocysteine and C-reactive protein levels, all of which are risk factors for cardiovascular disease.  Diet and exercise must be the primary consideration in treating and avoiding heart disease. 

      Since many Americans do not consistently eat a whole food diet or regularly exercise, it is important there is awareness of a group of nutrients that are critical to the health of the heart.  Four of these nutrients are produced by the body from raw materials provided by the diet and one of these nutrients must come directly from the diet.  A high quality diet is critical to these nutrients being operational in the body. If a high quality diet is not being consumed, supplementation with these nutrients may be necessary. The group of nutrients I am referring to are, Coenzyme Q10 (CoQ10), L-Carnitine, Taurine, D-Ribose and the mineral Magnesium.  These five nutrients are very important to the proper function of the heart.

COENZYME Q10 (CoQ10): 

      Coenzyme Q10 (CoQ10) occurs naturally in the cells of plants, animals and humans.   This fat soluble substance is used by cells to extract energy from food. CoQ10 is highly concentrated in heart muscle cells due to the high energy requirements of the heart. Congestive heart failure has been strongly correlated with significantly low blood and tissue levels of CoQ10.  Research has shown that the severity of heart failure correlates with the severity of CoQ10 deficiency.  People using Statin drugs to lower cholesterol levels must supplement with CoQ10 as Statins destroy this nutrient.  Some doctors have observed a marked increase in heart failure, among those using Statin drugs.  It even has a name, “Statin Cardiomyopathy.”  Anyone using Statins should take a CoQ10 supplement.

       CoQ10 is found in small amounts in a wide variety of foods but is particularly high in organ meats such as heart, liver and kidney, as well as beef, soy oil, sardines, mackerel, and peanuts. CoQ10 is also synthesized in the body from the amino acid tyrosine in a process requiring at least eight vitamins and several trace elements. You can see the importance of eating a quality diet in order for your body to make CoQ10. 

      The adult human body reserve of CoQ10 has been found to be approximately two grams (2000 milligrams) with the body requiring replacement of about 500 milligrams per day. This must be supplied either by synthesis in the body or obtained from food.  Synthesis within the body decreases progressively in humans after age 21. Since the average CoQ10 content of the western diet is less than 5 milligrams per day, it is difficult to maintain adequate CoQ10 levels unless you eat a very nutrition dense diet.  Therefore, supplementation with CoQ10 should be seriously considered. In a recent study reported in the May 22,2012 International Journal of Cardiology, it was shown that taking 200 mg of CoQ10 per day along with 200 mcg of the trace mineral selenium reduced the risk of dying due to cardiovascular disease by nearly 50%. Selenium is a mineral that is involved in the body's production of the important antioxidant enzyme glutathione peroxidase.  


       L-Carnitine is a dipeptide composed of the amino acids lysine and methionine, both of which must come from the diet as our bodies don’t make these amino acids.  Carnitine is manufactured in the liver and kidneys and is found in animal products.  This compound facilitates the transportation of fatty acids across cell membranes into the mitochondria of cells.  It is therefore important to the cells utilization of fats as a fuel source for producing energy.  Since the heart is the most energy intense organ in the body and uses fatty acids as a primary source of fuel, carnitine is of vital importance to coronary health.  People who have cardiovascular disease often exhibit carnitine deficiency.  Some research shows that angina may occur as a result of carnitine deficiency and the taking of 900 - 2,000 mg per day of supplemental carnitine may reduce the pain and other symptoms of angina.  Carnitine is stored primarily in the heart where it facilitates cardiac contractions.


        Taurine is the most abundant amino acid in the heart. It is present in the heart in greater quantities than all other amino acids combined.  Its primary function is to normalize potassium flow into and out of cardiac muscle cells, normalize the electrical excitability of the hearts cell membranes and enhance the contractile strength of the Cardiac Muscle.  Persons who have experienced a heart attack often exhibit very low taurine levels subsequent to their heart attack indicating that supplemental taurine may be highly advisable for persons who have experienced a heart attack or are experiencing coronary issues. The liver makes taurine from the amino acids cysteine and methionine. It is also found in most animal products. Methionine must be obtained from the diet as our body does not make it.


       D-ribose is a five-carbon sugar that is made in our cells from glucose and is instrumental in the production of adenosine triphosphate (ATP). It is also present in small amounts in food, primarily in muscle meats.  ATP is the basic energy producing molecule in the body.  Ribose provides the key building block of ATP, and the presence of ribose in the cell stimulates the metabolic pathway our bodies use to actually make ATP. If the cell does not have enough ribose, it cannot make ATP. Therefore, ribose is critical to the heart which utilizes a great deal of energy.  Ribose is made by the cells in response to metabolic demands of the body.  The process of making ribose is slow in the body and when metabolic demand suddenly increases, the body can’t always meet the demand in a timely manner.  For example, when there is a lack of oxygen to the heart resulting from a clogged artery inhibiting blood flow, the metabolic demands of the heart suddenly increase requiring greater ATP which requires more ribose.       

       Many years of research has shown ribose has a profound effect on heart function in patients with congestive heart failure, coronary artery disease, and Cardiomyopathy (a weakened heart muscle). In one study conducted at the University of Bonn in Germany, patients with congestive heart failure were treated with either 10 grams of ribose or a sugar placebo every day for three weeks. They were then tested for heart function, exercise tolerance and quality of life using a questionnaire designed for this purpose. In this study, ribose therapy had a significant effect on all measures of diastolic heart function, showing that increased energy in the heart allowed the heart to relax, fill, and pump more normally. Patients in the study were also much more tolerant of exercise when they were on ribose.

       Other studies have shown ribose supplementation increased oxygen utilization resulting in patients able to breathe better and use the oxygen they inhaled more efficiently. Improving ability to use oxygen means more oxygen is available to go into the blood and out to the tissues. Having more oxygen available allows the heart and all other muscles to burn fuel more efficiently, helping muscle to keep pace with energy demand.


       Magnesium is an alkaline macro mineral that functions as an electrolyte. Electrolytes are substances that can conduct an electric charge when in solution.  Magnesium is one of the principal intracellular electrolytes that conduct a positive electrical charge. Therefore, this electrolyte is very important to the heart muscle as it is used to maintain voltages across the hearts cell membranes and to carry electrical impulses to other cells.    

       Green vegetables such as spinach, romaine lettuce, kale and collards, are good sources of magnesium. Some legumes, nuts and seeds (almonds, cashews and walnuts) and unrefined grains are also good sources of magnesium. Refined grains have much of their magnesium removed.  Data from the 1999-2000 National Health and Nutrition Examination Survey suggest that substantial numbers of adults in the United States fail to consume recommended amounts of magnesium. The average Western dietary intake of magnesium is 200 mg per day for women and 240 mg per day for men.  The optimal daily allowance of magnesium for adults is 500 - 1,000 mg per day depending on weight.  

       Researchers have determined that congestive heart failure is often associated with abnormally low blood magnesium levels and low tissue magnesium levels.  Magnesium deficiency in congestive heart failure patients can lead to cardiac arrhythmias and sudden cardiac death.  Magnesium deficiency may contribute to the increase in peripheral vascular resistance commonly observed in congestive heart failure patients. Since the body does not produce magnesium, all your magnesium must come from the diet. 

      The five nutrients discussed here are critical to the health and function of the heart. If you are not eating the kind of diet that provides the body with adequate amounts of magnesium or adequate amounts of the raw materials to produce the four other nutrients discussed in this essay, these nutrients are all available as supplements. Now let's look at two nutritional components that are often seen as being a negative factor to the health of the heart, cholesterol and triglyceride fat. 


       The best known fat is cholesterol which has the very important function of keeping the membranes of our cells functioning properly. This function is so important that every cell in your body has the ability to synthesize cholesterol.  The liver, intestines, adrenal glands and sex glands also make cholesterol as necessary. All steroid hormones are made from cholesterol.  Vitamin D is, in part, synthesized from cholesterol.  Bile acids, secreted into the small intestine from the gall bladder, are made from cholesterol and play a vital role in the digestion of fats consumed in the diet.  Finally, cholesterol is secreted by glands in the skin to protect the skin from dehydration.

        Dietary cholesterol is only found in animal products. When you see non-animal products being touted as “cholesterol free” this is simply marketers trying to make you believe buying their product provides a heath advantage.  Dietary cholesterol provides only a small percentage of the total cholesterol found in the body.  The liver produces 70 to 80 percent of your body’s cholesterol. It should be noted, however, that eating a diet high in triglyceride fat tends to elevate the livers production of cholesterol. This also occurs with the consumption of a lot of hydrogenated fats and oils.

       Triglycerides are an example of a fat largely made up of saturated fatty acids.  This fat is a chemical combination of three fatty acids held together by a liquid alcohol called glycerol.  Triglycerides are the major form of dietary and body fat. While limiting consumption of dietary cholesterol may only produce mild reduction in total cholesterol levels, reducing triglyceride dense foods such as meats and dairy products can help to significantly reduce triglyceride levels in the body and lower the livers production of cholesterol.  Therefore, reducing consumption of triglycerides is an important consideration in reducing the potential for cardiovascular disease.   

       The primary problem with cholesterol is that the so-called bad LDL and VLDL (low and very low density lipo protein) cholesterol can oxidize and create free radical activity causing damage to the walls of the arterial system.  One way to guard against such oxidation is to insure that you are consuming a large variety of anti-oxidant nutrients on a daily basis.  HDL, (high density lipo protein) the so-called good cholesterol, helps to remove LDL cholesterol by collecting it and returning it to the liver. Aerobic and resistive exercise is the best way to raise HDL levels.

       You can lower LDL cholesterol levels in the body by moving bile through the colon and out the stool.  Bile is basically a cholesterol waste product and failure to remove it can result in excess cholesterol circulating in the arterial system, which may end up as deposits in the arteries. Consuming thirty to forty grams of water soluble fiber per day will insure the elimination of cholesterol waste.  Oat bran, rice bran, apple pectin, flax fiber and psyllium are all examples of fibers that will facilitate this process. 


       Many people are using prescription Statin drugs such as lovastatin, Lipitor and Mevacor to lower cholesterol levels. Statins lower cholesterol by inhibiting the enzyme HMG-CoA Reductase that catalyzes the production of cholesterol in the liver. Such drugs have a very modest effect on raising HDL levels and do not lower triglycerides.  The mechanism by which Statin drugs lower cholesterol also inhibits the biosynthesis of CoQ10 in the liver.  As discussed last month, CoQ10 is absolutely necessary for proper function of the heart. Some doctors have observed a marked increase in heart failure, among those using Statin drugs.  It even has a name, “Statin Cardiomyopathy.”  Anyone using Statins should take a CoQ10 supplement. 

       Muscle pain and muscle wasting, cognitive impairment, blurred vision, nerve damage and liver damage are some of the side effects that have been reported with the use of Satin drugs.  These side effects markedly increase as dosage levels of Statins are increased.  


       A standardized extract of Red Yeast Rice, contains the compound Monacolin-K that has been found to lower cholesterol by inhibiting the enzyme HMG-CoA Reductase just as Statins but without the side effects associated with Statins.  In addition to lowering cholesterol, Red Yeast Rice Extracts have been found to also lower triglycerides and raise HDL levels.  Red yeast rice is made by fermenting polished rice with various yeasts. It is a common seasoning agent in Asian countries.  In 2006 an analysis was done of 93 randomized controlled trials involving over 10,000 Chinese patients with elevated cholesterol and triglycerides.  It was found that supplementation with Red Yeast Rice Extract significantly lowered cholesterol and triglyceride levels while raising HDL levels compared to placebo controls.  

       Since Red Yeast Rice extracts can interfere with CoQ10 production just like Satins, users should supplement with CoQ10.  Red Yeast Extract with CoQ10 in a single formula is available at Milk ‘N Honey. 

       Cautionary note:  When Statins or Red Yeast Rice products are consumed in conjunction with Grapefruit juice, the blood concentration of their active ingredients is increased by up to 15-fold.  Such increases are dangerous.  Don’t drink grapefruit juice when taking these products. 


       Another natural substance shown to lower cholesterol is Policosanol, a lipid alcohol derived from sugar cane wax.  A number of studies show this substance to effectively lower total cholesterol, raise HDL levels and guard against LDL oxidation.  This product is well tolerated and has no significant side effects.  Policosanol is available at Milk ‘N Honey.


       Pantethine is the active form of vitamin B5 which is pantothenic acid.  This nutrient is involved in making co-enzyme A (CoA) which is involved in the transport, synthesis and oxidation of fatty acids in the mitochondria of the cells where the ATP energy molecule is made.  A number of studies have demonstrated Pantethine supplementation to produce significant reduction in total cholesterol, LDL levels, LDL to HDL ratios and triglycerides levels.


        Plant sterols are substances that occur naturally in small amounts in many grains, vegetables, fruits, legumes, nuts, and seeds. Sterols look a lot like cholesterol. When they travel through your digestive tract, they can compete with and prevent cholesterol from being absorbed into your bloodstream.  In a 2005 study, the sterol Beta-Sitosterol was shown to reduce LDL levels by up to 27%.  Beta-Sitosterol is available at Milk ‘N Honey as a supplement. 


        Niacin (vitamin B3) is a well documented agent for the lowering of both cholesterol and triglyceride levels.  This substance will bring down LDL and raise HDL.  The down side of supplementing with Niacin is that it dilates the blood vessels close to the skin and causes an uncomfortable flush (redness and prickly feeling).  A form of Niacin called inositol hexaniacinate does not cause flushing but is not as effective as straight Niacin in its action on cholesterol and triglycerides. 

       The best protection against heart disease is a nutritionally dense whole food diet supplemented with plenty of exercise.  If this approach is lacking, then it is important to consider the forgoing recommendations.